NASHVILLE (AP) — Democrat gubernatorial candidate Karl Dean said Tuesday he would happily sign Medicaid expansion into law in Tennessee, while his opponent Republican Bill Lee countered he would oppose such efforts.

The two top candidates detailed their positions during the second gubernatorial debate at the Toy F. Reid Employee Center in Kingsport. Similar to the first debate, Dean and Lee refrained from aggressively attacking each other in an overall tame event — with Lee even making a point to thank Dean's positive tone throughout the campaign during the opening remarks.

However, the two made sure to split on key health care and education issues over the course of the one-hour debate.

"We have literally given up $4 billion. That is money being spent in other states," Dean said. "There are now billboards in Tennessee that say 'thank you for paying for our health care.' We need to get our Medicaid dollars back here."

Under the Affordable Care Act, the U.S. government pays at least 90 percent of the cost of expanding Medicaid while states pick up the rest. Despite the savings promoted by supporters, Tennessee lawmakers have long refused to consider expanding its Medicaid program — known as TennCare — even with Republican Gov. Bill Haslam advocating for the change.

That opposition would continue under Lee's administration should the Republican win in November.

"Taking federal money is not free money," Lee said. "We shouldn't expose Tennesseans to that. We expanded Medicaid before, it ended up failing and it almost broke the state."

In 2003, the former Gov. Phil Bredesen found a way to stem budget gaps and exploding cost growths at TennCare by cutting 170,000 adults from the program and reducing benefits to thousands more.

Lee did not provide specific details during the debate on what exactly he would do to improve health care access and lower costs, but later told reporters he believed he could help oversee better coordinated care and utilizing technology — such as telemedicine — as governor within the first few years.

On education, Dean criticized Lee's support of using vouchers that use taxpayer money to pay for tuition to private or religious schools.

"I do not believe in vouchers, vouchers actually take dollars way from the public education system," Dean said.

Lee said he supports giving families more choices and flexibility to give the best option to their kids and would make sure he would do nothing to diminish the quality of public education. He never used the word voucher in his response.

"I believe that choice is very important," he said.

Lee, who is running for political office for the first time, made multiple references to his Franklin mechanical contracting, facilities and home services company to serve as examples of his leadership style, referencing his ability to navigate during lean budget years and managing health care costs spikes.

"In business, if you don't manage a budget you go bankrupt," he said. "In government, if you don't manage a budget, you raise taxes."

Dean, former Nashville mayor, disagreed with Lee's assessment.

"I have been in government and that's not how it works," Dean said. "We had to make all of the tough decisions a government has to make. We had to make the cuts and we had to eliminate positions."

Dean and Lee are vying to replace term-limited Republican Gov. Bill Haslam

A third debate has also been scheduled for this week on Oct. 12 in Nashville.